La simulación clínica en la adquisición de conocimientos en estudiantes de la Licenciatura de Enfermería / Clinical simulation in acquisition of knowledge among undergraduate nursing students / A simulação clínica na aquisição de conhecimentos em estudantes da Licenciatura de Enfermagem

Resumen Introducción: La simulación clínica es una herramienta educativa que permite a los estudiantes de enfermería experimentar la representación de un hecho real, para practicar, aprender y adquirir los conocimientos necesarios para el desempeño de su profesión. En Oaxaca, la Universidad de la Sierra Sur (UNSIS), tiene una clínica robotizada, que apoya a los estudiantes en el desarrollo de su práctica clínica, pero aún no cuenta con una metodología específica para llevar a cabo simulación clínica. Objetivo: Comparar la adquisición de conocimientos en estudiantes de enfermería con el método tradicional y otro basado en simulación clínica. Metodología: Estudio de pre y postest para evaluar conocimiento del tema trabajo de parto en alumnos de 4° semestre; se compararon dos metodologías, la tradicional utilizada en la universidad y otra basada en simulación clínica; la primera consistió en dar la clase teórica en aula y replicarla con un simulador; la segunda consistió en clase teórica, escenario de simulación clínica, caso clínico y debriefing. Resultados: Hubo diferencia estadísticamente significativa (p <.001) entre pretest y postest en ambas metodologías, pero quienes recibieron la metodología basada en simulación clínica obtuvieron mayores puntajes (p=0.004). Discusión: El uso de una metodología basada en simulación clínica permitió que los alumnos obtuvieran mayores conocimientos en el tema trabajo de parto, respecto a la metodología tradicional que se utiliza en la universidad. La UNSIS empieza a generar evidencia sobre el uso de la simulación clínica adaptada a su modelo educativo. Conclusiones: Utilizar la simulación clínica logró que los estudiantes obtuvieran mayores conocimientos.

Abstract Introduction: Clinical simulation is an educational tool which allows nursing students to experience representations of real events in order to practice, learn, and acquire the necessary knowledge to perform in their profession. In Oaxaca, Mexico, the Universidad de la Sierra Sur (UNSIS), has a robotic clinic which helps nursing students in their clinical learning; however, a specific clinical simulation methodology needs to be developed. Objective: To contrast the acquisition of knowledge among nursing students as a result of using the traditional method in comparison to using a method based on clinical simulation. Methodology: This is pre and post-test study to assess the knowledge development related to labor among nursing students from the 4th semester. Two teaching methodologies were compared: the traditional one, which included classroom classes and a replication using a simulator, and the clinical simulation based one, which included classroom classes, a clinical simulation scenario, a clinical case, and a debriefing session. Results: Statistically significant differences (p <.001) were found between the pre and post test knowledge status with both teaching methodologies; but the improvement of those who learned through the clinical simulation based methodology was higher (p=0.004). Discussion: The use of the methodology based on clinical simulation allowed the students to acquire more knowledge on labor among in comparison to the use of the traditional methodology. The UNSIS is now collecting evidence on the use of clinical simulation in order to adapt this methodology to its educational model. Conclusion: The use of clinical simulation resulted in the acquisition of more knowledge by the nursing students.

Resumo Introdução: A simulação clínica é uma ferramenta educativa que permite aos estudantes de enfermagem experimentar a representação de um fato real, para praticar, aprender e adquirir os conhecimentos necessários para o desempenho de sua profissão. Em Oaxaca, a Universidad de la Sierra Sur (UNSIS), tem uma clínica robotizada, que apoia aos estudantes no desenvolvimento de sua prática clínica, mas ainda não conta com uma metodologia específica para levar a cabo simulação clínica. Objetivo: Comparar a aquisição de conhecimentos em estudantes de enfermagem com o método tradicional e outro baseado na simulação clínica. Metodologia: Estudo de pre e postest para avaliar conhecimento do tema trabalho de parto nos alunos de 4° semestre; compararam-se duas metodologias, a tradicional utilizada na universidade e outra baseada em simulação clínica; a primeira consistiu em dar a aula teórica na sala e replicá-la com um simulador; a segunda consistiu na aula teórica, cenário de simulação clínica, caso clínico e debriefing. Resultados: Houve diferença estatisticamente significativa (p <.001) entre pretest e postest em ambas as metodologias, mas aqueles que receberam a metodologia baseada em simulação clínica obtiveram maiores pontuações (p=0.004). Discussão: O uso de uma metodologia baseada em simulação clínica permitiu que os alunos obtivessem maiores conhecimentos no tema trabalho de parto, ao respeito da metodologia tradicional que se utiliza na universidade. A UNSIS começa a gerar evidência sobre o uso da simulação clínica adaptada a seu modelo educativo. Conclusões: Utilizar a simulação clínica conseguiu que os estudantes obtivessem maiores conhecimentos.

Consistency in bird use of tree cover across tropical agricultural landscapes.

In tropical regions where forests have been replaced by agriculture, the future of biodiversity is increasingly dependent on the presence of remnant forest patches and on-farm tree cover within agricultural landscapes. While there is growing evidence of the importance of tree cover within agricultural landscapes, most studies have been conducted in a single landscape, making it difficult to ascertain whether the conservation value of different types of tree cover can be generalized across landscapes. To explore whether use of different forms of tree cover by birds is consistent across landscapes, we compared the number of individuals, species richness, and diversity of birds associated with different forms of tree cover in four agricultural landscapes in Central America, using a standardized methodology and sampling effort. In each landscape, we compared bird assemblages in six tree cover types (secondary forests, riparian forests, forest fallows, live fences, pastures with high tree cover, and pastures with low tree cover). We observed a total of 10 723 birds of 283 species, with 83-196 species per landscape. The specific patterns of bird species richness, number of individuals, and diversity associated with tree cover types varied across the four landscapes, but these variables were consistently higher in the forest forms of tree cover (riparian forests, secondary forests, and forest fallows) than in non-forest habitats. In addition, forest forms of tree cover had distinct species composition from non-forest forms in all landscapes. There was also consistency in the use of different types of tree cover by forest birds across the four landscapes, with higher richness and number of individuals of forest birds in forested than non-forested forms of tree cover, and more forest bird species in pastures with high tree cover than in pastures with low tree cover. Our findings indicate that riparian and secondary forests are consistently of higher value for bird conservation (particularly for forest species) than live fences and pastures with tree cover. Consequently, agricultural and land use policies that promote the retention of secondary and riparian forests and increase tree cover within pastures would greatly benefit bird conservation, regardless of the landscape in which they are applied.

[Asymptomatic bacteruiria frequency in pregnant women and uropathogen in vitro antimicrobial sensitivity]. / Frecuencia de bacteriuria asintomática en embarazadas y sensibilidad antimicrobiana in vitro de los uropatógenos.

OBJECTIVES: To estimate the frequency of asymptomatic bacteriuria in pregnant women attended in Family Medicine Units of the Instituto Mexicano del Seguro Social and to determine the in vitro sensitivity rate of the microorganisms to ampicillin, trimethoprim-sulfamethoxazole, nitrofurantoin and amikacin. PATIENTS AND METHODS: We carried out an observational, prospective and transversal study at Family Medicine Units 62 and 64 of the Mexico State Delegation, located in the urban area of Mexico City. Women with lesser than 32 weeks of pregnancy without urinary tract symptoms were included. Urine culture of a midstream urine specimen with > or = 10(5) colony forming units/mL urine of an only germen was used as the gold standard. The in vitro antimicrobial sensitivity was established according to the Bauer Kirby technique. RESULTS: 874 pregnant women were included and 73 had a positive urine culture, with a frequency of 8.4%, IC 95% = 6.6 - 10.2%, of asymptomatic bacteriuria. Escherichia coil was the most frequent isolated agent (77%). In vitro sensitivity to ampicillin of the microorganisms isolated was of 27%, IC 95% = 16 - 38%; to trimethoprim-sulfamethoxazole of 40%, IC95% = 29 - 51%; to amikacin of 68%, IC 95% = 57 - 79%, and to nitrofurantoin of 79%, IC 95% = 70 - 88%. CONCLUSIONS: The frequency of asymptomatic bacteriuria in the studied population is similar to the reported by the literature. The in vitro sensitivity rates of E. coil to ampicillin and to trimethoprim-sulfamethoxazole are very low. The best sensitivity corresponded to the nitrofurantoin. The treatment of the asymptomatic bacteriuria must be based on the local patterns of antimicrobial sensitivity and resistance.

Patterns of animal diversity in different forms of tree cover in agricultural landscapes.

As tropical regions are converted to agriculture, conservation of biodiversity will depend not only on the maintenance of protected forest areas, but also on the scope for conservation within the agricultural matrix in which they are embedded. Tree cover typically retained in agricultural landscapes in the neotropics may provide resources and habitats for animals, but little is known about the extent to which it contributes to conservation of animal species. Here, we explore the animal diversity associated with different forms of tree cover for birds, bats, butterflies, and dung beetles in a pastoral landscape in Nicaragua. We measured species richness and abundance of these four animal taxa in riparian and secondary forest, forest fallows, live fences, and pastures with high and low tree cover. We recorded over 20,000 individuals of 189 species including 14 endangered bird species. Mean abundance and species richness of birds and bats, but not dung beetles or butterflies, were significantly different among forms of tree cover. Species richness of bats and birds was positively correlated with tree species richness. While the greatest numbers of bird species were associated with riparian and secondary forest, forest fallows, and pastures with >15% tree cover, the greatest numbers of bat species were found in live fences and riparian forest. Species assemblages of all animal taxa were different among tree cover types, so that maintaining a diversity of forms of tree cover led to conservation of more animal species in the landscape as a whole. Overall, the findings indicate that retaining tree cover within agricultural landscapes can help conserve animal diversity, but that conservation efforts need to target forms of tree cover that conserve the taxa that are of interest locally. Preventing the degradation of remaining forest fragments is a priority, but encouraging farmers to maintain tree cover in pastures and along boundaries may also make an important contribution to animal conservation.

Diversidad, composición y estructura de la vegetación en un agropaisaje ganadero en Matiguás, Nicaragua / Vegetation diversity, composition and structure in a cattle agro-landscape of Matiguás, Nicaragua

Se caracterizó la diversidad, composición y estructura de la vegetación en un paisaje ganadero en Matiguás, Nicaragua, y se comparó las diferencias florísticas y estructurales de seis tipos de hábitats (bosques secundarios, bosques ribereños, charrales, cercas vivas y potreros con alta y baja cobertura arbórea). Se registraron un total de 3 949 árboles de 180 especies y 52 familias. El 46% del total de especies informadas para el paisaje fueron representadas por Guazuma ulmifolia (18.5%), Bursera simaruba (13.2%), Tabebuia rosea (6.3%), Enterolobium cyclocarpum (4.2%) y Albizia saman (3.4%). Muchas de las especies dominantes en el paisaje son típicas de áreas abiertas y perturbadas. Se encontraron diferencias significativas entre los diferentes hábitats en los patrones de riqueza, abundancia, diversidad, estructura y composición florística. Los bosques ribereños tuvieron mayor riqueza (p=0.0001) y diversidad de especies (p=0.0009), que los demás hábitats. La composición florística vario entre hábitats, con pares de hábitats compartiendo solamente entre 18.4 y 51.6% de las mismas especies arbóreas, y con claras diferencias en composición entre los hábitats forestados (ribereños y bosques secundarios) y los hábitats agropecuarios. De los hábitats estudiados los bosques ribereños y bosques secundarios parecen ser los hábitats que tienen mayor valor para la conservación de la flora en el agropaisaje porque tienen la mayor riqueza de especies, además de que mantienen poblaciones bajas de especies maderables en peligro de extinción. En base a este estudio, recomendamos incluir los paisajes agrícolas en estrategias de conservación y sugerimos algunos criterios para asegurar el mantenimiento de la flora en el paisaje de Matiguás

The diversity, composition and structure of vegetation in a cattle landscape in Matiguás, Nicaragua was characterized, and the floristic and structural differences of six types of habitats (secondary forests, riparian forests, charrales, live fences and pastures with high and low tree cover) were compared. A total of 3 949 trees of 180 species and 52 families were recorded. Forty six percent of the total trees reported for the landscape were represented by Guazuma ulmifolia (18.5%), Bursera simaruba (13.2%), Tabebuia rosea (6.3%), Enterolobium cyclocarpum (4.2%) and Albizia saman (3.4%). Many of the dominant species in the landscape were typical of open and disturbed areas. There were significant differences between the different habitats in the patterns of tree species richness, abundance, diversity, structure and floristic composition. The riparian forests had greater tree richness (p=0.0001) and diversity (p=0.0009) than other habitats. The floristic composition varied across habitats, with pairs of habitats sharing between 18.4 and 51.6% of the same tree species, and with clear differences in composition between the forested (riparian and secondary forests) and agricultural habitats. Of the habitats studied, the riparian forests and secondary forests seem to have greatest value for the conservation of the flora in the agropaisaje because they have the greatest species richness, and maintain small populations of endangered species. On the basis of the study, we recommend including agricultural landscapes in strategies to conserve tree diversity and suggest measures to ensure the maintenance of tree diversity in the Matiguas landscape

[Vegetation diversity, composition and structure in a cattle agro-landscape of Matiguás, Nicaragua]. / Diversidad, composición y estructura de la vegetación en un agropaisaje ganadero en Matiguás, Nicaragua.

The diversity, composition and structure of vegetation in a cattle landscape in Matiguás, Nicaragua was characterized, and the floristic and structural differences of six types of habitats (secondary forests, riparian forests, charrales, live fences and pastures with high and low tree cover) were compared. A total of 3 949 trees of 180 species and 52 families were recorded. Forty six percent of the total trees reported for the landscape were represented by Guazuma ulmifolia (18.5%), Bursera simaruha (13.2%), Tabebuia rosea (6.3%), Enterolobium cyclocarpum (4.2%) and Albizia saman (3.4%). Many of the dominant species in the landscape were typical of open and disturbed areas. There were significant differences between the different habitats in the patterns of tree species richness, abundance, diversity, structure and floristic composition. The riparian forests had greater tree richness (p=0.0001) and diversity (p=0.0009) than other habitats. The floristic composition varied across habitats. with pairs of habitats sharing between 18.4 and 51.6% of the same tree species, and with clear differences in composition between the forested (riparian and secondary forests) and agricultural habitats. Of the habitats studied, the riparian forests and secondary forests seem to have greatest value for the conservation of the flora in the agropaisaje because they have the greatest species richness, and maintain small populations of endangered species. On the basis of the study, we recommend including agricultural landscapes in strategies to conserve tree diversity and suggest measures to ensure the maintenance of tree diversity in the Matiguas landscape.